Healing the City: Popular Notions of Health and Citizenship Rights in São Paulo, 1976–90

This paper explores the emergence and trajectory of a health-based rights discourse in São Paulo’s Zona Leste (East Zone) from 1976 to 1990. Amidst Brazil’s military dictatorship (1964-85), residents of the Zona Leste founded successive social movements to demand urban infrastructure improvements and better state services. Still active today, the popular Health Movement stands out as the largest such movement and perhaps the most successful in influencing Brazil’s transition to democracy. Based on original interviews and documents from activists’ private collections, I examine how neighborhood activists drew from their experiences of urban problems to develop a popular medical framework for citizenship rights in a democratic Brazil. Premised on the idea of improving the health of urban residents, this framework came to encompass a staggering array of social issues beyond simply healthcare: food, cost of living, environmental conditions, childcare, sanitary infrastructure, and transportation. As Brazil moved slowly towards democracy in the late 1970s and early 1980s, activists pushed for expanded rights in these areas as well as for popular participation in Brazil’s healthcare system, helping lead to the eventual emergence of the Sistema Única de Saúde (Unified Health System) in 1990. By analyzing the shifting meanings of health and citizenship, we can better understand how activists in São Paulo created a compelling urban imaginary that tied their own health and prospects to that of their city and in the process, reimagined what democratic Brazilian citizenship would look like.